Re: Don't go from an emergency-certified network to a consumer network

You bring up some good points, CommsEngineer, especially when you add BYOD to the mix. Then, in addition to the technical issues you cite regarding cell networks, you have a mix of older and newer phones, and individuals' potential non-payment or limits on their texting/calling plans. These concerns could well be one reason so many hospitals apparently have opted to stay with pagers, especially as one study (and I cannot for the life of me remember where I read or heard about it although I'll try to dig it up) found that nurses prefer carrying two devices (doctors would rather carry one).

I read your article with interest, but as an RF systems designer, I think you overlooked an important point.

Everyone loves their 'cell'; it is their be-all and end-all of technology....many think it talks to satellites, and that the only things it can't do are things that no one has thought of writing an app for. It is, frankly, all they know in the communications world.

However, despite references to "HIPPA", the handy program that seems to be able to make or break any argument on medical matters regardless of the position, there is something FAR more important:

The cellular infrastructure is haphazard, fragmented, constructed in vastly different ways by varying carriers, and is simply NOT a defined life-safety system. Very, very few cellular base stations have back up power for more than a couple of hours of run time, and 1 in 20 has a generator. Backhaul routes from the sites to the cellular MTSOs are least-cost, non-redundant, and easily disrupted.

It does, and often has, completely collapse under heavy system load, or in the event of natural disaster. I point to the Boston Marathon, any busy sports or entertainment venue, earthquakes (even minor ones)....essentially anywhere great numbers of subscribers reach for the beloved 'cell' at once.

I can imagine the problems when Nurse Jones' battery dies, the service is cut off for a missed payment, or she decided to upgrade and change numbers without efficiently notifying the world.

Cellular infrastructure is fine for this posting I'm typing, two teenagers planning to cut class, or for planning lunch with a friend. But, for my upcoming surgery, when I need a pint of blood, I don't want it to depend on Nurse Jones knowing Dr. Brown's personal mobile number, both accounts being up to date, equipment being in good shape, and the system working. Even if hospital-subscribed, properly cleaned and maintained devices are used, it's still a consumer network, built with precious little redunancy, and engineered for sunny-day, normal conditions.

Regardless of the 'trendiness' of the 'cell', calls for the removal of healthcare-agency engineered, controlled, and operated life-safety communications systems are specious, and downright dangerous.

I'll trade you all the HIPPAs in the world for a reliable public-safety grade, properly installed and engineered, well-backed up professional communications system.

Sure, any item a doctor or nurse handles or carries needs to be kept clean. This is "the devil I know vs. the devil I don't" tradeoff, where there are established practices and policies for pagers that need to be adapted to smartphones. As background reading, I found this blog post from Rock Health (which invests in health IT startups) laying out the reasons why the boring but reliable old technology of pagers still trumps novel smartphone tech in many ways.

You wear a pager on your belt and put your hands on it just like a smart phone, so how is it any different from a germ perspective? Okay, you certainly use the smart phone more than a pager, and you would use it outside of the work environment. But doctors and nurses don't take those pagers off when they leave the hospital. Everything needs a swipe, right?

It's hard to imagine someone who needs quick and easy communications more than a nurse. I wonder if the nurses' needs are being dealt with second in line, after the doctors' needs? Also, how do tablets fit in here? Aren't more nurses being asked to use tablets to work with patient records as they move around the floor? It seems like IM on tablet would be faster than pages.

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